SUN-229 CLINICAL OUTCOMES OF HEMOPERFUSION USING HA 330 FILTER AMONG PATIENTS WITH SEPSIS IN ST. LUKE'S MEDICAL CENTER

Abstract

Hemoperfusion is among the extracorporeal blood purification therapies proposed to improve outcomes in sepsis by removing inflammatory mediators from the blood. Results of earlier studies are conflicting and more studies are needed to validate the efficacy of hemoperfusion in improving the outcome among patients with sepsis. The aim of this study is to determine the clinical outcomes of hemoperfusion using sepsis (Jafron HA 330) filter among patients with sepsis. There were 49 patients with severe sepsis and septic shock who underwent hemoperfusion with sepsis (Jafron HA 330) filter, 8 patients were excluded based on the exclusion criteria. We retrospectively investigated 41 patients and reviewed their demographic data, routine biochemistry, microbiological data, focus of infection, Acute Physiology and Chronic Health Evaluation (APACHE) II score, procalcitonin level, mean inotropic score, duration of mechanical ventilation and intensive care unit (ICU) stay, and ICU and 28- day mortality rate. We compared the characteristics of patients who survived and did not survive after 28 days and their mean arterial pressure (MAP), inotropic score, creatinine, APACHE II score, procalcitonin before and after hemoperfusion treatment. The ICU mortality rate and 28-day mortality rate were 46.34% and 41.6% respectively which are lower than the predicted mortality rate of 49.70% based on the APACHE II score before hemoperfusion treatment and 54% among patients with septic shock. The mean duration of ICU stay is 23.0 ±26.66 and the mean duration of mechanical ventilation is 21.0 ±27.02. There is a significant difference between the non-survivors and the survivors in terms of duration of ICU stay (p =0.006), duration of mechanical ventilation (p =0.029), number of hemoperfusion treatments (p =0.007) and timing of hemoperfusion (p =0.006). Among the survivors, 11 (45.83%) had early hemoperfusion ( treatment has significant effect on the duration of ICU stay (p = 0.008) and duration of mechanical ventilation (p =0.016). The result shows no significant difference in APACHE II score, inotropic score, hospital stay and renal recovery between early and late hemoperfusion (>48 h) treatment. One patient had bleeding after hemoperfusion treatment. Among the survivors and non-survivors, there was no significant reduction in platelet count before and after hemoperfusion treatment (p =0.179, 0.791 respectively). Other reactions such as fever and chills were not observed. Hemoperfusion treatment results in lower ICU and 28-day mortality rate. Hemoperfusion has significant effect on the duration of ICU stay and mechanical ventilation. We recommend early hemoperfusion (within 48 hours of diagnosis of sepsis) because it is a significant factor in decreasing ICU and 28-day mortality. Early hemoperfusion treatment also has significant effect on the duration of ICU stay and mechanical ventilation. There were no serious adverse reactions reported during the duration of observation.